This invention relates generally to instruments for use in minimally invasive surgery, including laparoscopic surgery. More particularly, this invention relates to improved body cavity penetrating instruments for use in minimally invasive surgical techniques, namely insufflation needles and trocar/sleeve assemblies. These improved instruments are adapted to signal proper placement into body cavities (pleural, peritoneal and pericardial) and into potential spaces created in the preplural, properitoneal and prepericarial areas for introducing fluid or mechanical devices.
A host of minimally invasive surgical techniques intended to replace conventional surgical procedures and reduce the trauma of entering the body cavities and potential spaces are currently being developed. These new surgical techniques reduce morbidity and mortality, make it easier to manage the danger of infection, and accelerate recovery and the patient's safe return to full activity.
Current minimally invasive surgical techniques include laparoscopic, endoluminal, perivisceral, endoscopic, thoracoscopic, intra-articular and hybrid approaches. For example, the laparoscopic approach is currently being used in performing cholecystectomy, appendectomy, herniorrhaphy, hysterectomy, vagotomy, pericardiotomy, esophagectomy, hysterectomy, oophorectomy, gastral and bowel resections, nephrectomy, etc.; the thoracoscopic approach is being used in sympathectomy, vagotomy, and excision and closure of bullae and mechanical and chemical pleurodesis and lung resections; and, finally, the intra-articular (arthroscopic) approach is being used in connection with meniscectomy and the remedy of other joint dysfunctions.
An example of a currently widely employed minimally invasive surgical technique is cholecystectomy. In this procedure, as in the other minimally invasive surgical techniques performed in the abdominal cavity, an insufflation needle is inserted into the abdominal cavity through a small incision in the abdominal wall and the peritoneum, and the cavity is insufflated with an insufflating gas, such as carbon dioxide, which is passed through the insufflation needle. The needle is then removed, a trocar/sleeve assembly is inserted at the needle puncture into the insufflated abdomen, the trocar is removed, and an endoscopic camera is inserted into the abdominal cavity through the port of the trocar sleeve. Then, additional incisions are made at strategic locations in the abdominal wall and, under direct visualization, secondary trocar/sleeve assemblies are introduced to provide access for surgical instruments necessary to perform the cholecystectomy.
The insufflation needle and trocar/sleeve assemblies are sharp instruments designed to readily pierce and penetrate into the peritoneal or other body cavity or potential space. In the present state of the art, the sharp tips presented by these devices are shielded by retractable safety devices to prevent injury to underlying structures as the devices are passed into proper position in the body cavities and potential spaces. Nevertheless, when pushed into the body cavities or potential spaces the instrument tips can nick or puncture vessels, organs or other structures contained therein causing serious injury to the patient. On the other hand, if the tip of the instrument is not pushed far enough through the wall of the cavity or space it will not be possible to properly insufflate through the insufflation needle, additional unnecessary trauma may occur and the minimally invasive surgical procedure will be delayed.
Current insufflation needles and trocar/sleeve assemblies do not adequately signal when the devices are properly positioned in the body cavity or potential space in which the minimally invasive surgical procedures are to proceed.
It is therefore an object of the present invention to provide sharp pointed instruments for penetrating body cavities or potential spaces for minimally invasive surgery in which an indication is provided to the surgeon when the instruments are properly placed within the body cavities or potential spaces.
Another object of the present invention is to provide such instruments with means for sensing the pressure within the body cavities or potential spaces.
A further object of the present invention is to provide such instruments with means for giving the surgeon a visual indication of when the instruments enter the body cavities or potential spaces.
Yet another object of the present invention is to provide such instruments with means for giving the surgeon a tactile indication of when the instruments enter the body cavities.
These and other objects and advantages of the invention will become apparent to those skilled in the art upon consideration of the accompanying specification, drawings and claims.